Contract Pharmacy Details

SINA DRUG LLC
DSH330127 JACOBI MEDICAL CENTER (NYCHHC)

Covered Entity Details

Entity Name

JACOBI MEDICAL CENTER (NYCHHC)

Subdivision Name

FORMERLY BRONX MUNICIPAL HOSPITAL

Type

Disproportionate Share Hospital

340B ID

DSH330127

Entity Address

1400 PELHAM PKWY SOUTH
BRONX, NY 10461

Medicare Provider Number

330127

Participating Start Date

12/1/1992

Last Recertification Date

9/3/2024

Pharmacy Details

Pharmacy Name

SINA DRUG LLC

Pharmacy Address

DBA ONCO360
1985 MARCUS AVE STE 120
NEW HYDE PARK, NY 11042

Pharmacy Comments

08/02/2012 corrected name (was OncoMed Pharmacy)

Contract Details

Approval Date

7/13/2018

Contract Begin Date

10/1/2018

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Paul Albertson, Vice President
(212) 748-2256

Contract Pharmacy Representative

Onco360 Oncology Pharmacy
Jim Bozora, VP of 340B Oncology Sales
(702) 281-5985

Signed By Date

7/13/2018

340B Drug Pricing Program Database